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Comparison of two minimally invasive surgery strategies to treat adult spinal deformity.

Publication ,  Journal Article
Park, P; Wang, MY; Lafage, V; Nguyen, S; Ziewacz, J; Okonkwo, DO; Uribe, JS; Eastlack, RK; Anand, N; Haque, R; Fessler, RG; Kanter, AS ...
Published in: J Neurosurg Spine
April 2015

OBJECT: Minimally invasive surgery (MIS) techniques are becoming a more common means of treating adult spinal deformity (ASD). The aim of this study was to compare the hybrid (HYB) surgical approach, involving minimally invasive lateral interbody fusion with open posterior instrumented fusion, to the circumferential MIS (cMIS) approach to treat ASD. METHODS: The authors performed a retrospective, multicenter study utilizing data collected in 105 patients with ASD who were treated via MIS techniques. Criteria for inclusion were age older than 45 years, coronal Cobb angle greater than 20°, and a minimum of 1 year of follow-up. Patients were stratified into 2 groups: HYB (n = 62) and cMIS (n = 43). RESULTS: The mean age was 60.7 years in the HYB group and 61.0 years in the cMIS group (p = 0.910). A mean of 3.6 interbody fusions were performed in the HYB group compared with a mean of 4.0 interbody fusions in the cMIS group (p = 0.086). Posterior fusion involved a mean of 6.9 levels in the HYB group and a mean of 5.1 levels in the cMIS group (p = 0.003). The mean follow-up was 31.3 months for the HYB group and 38.3 months for the cMIS group. The mean Oswestry Disability Index (ODI) score improved by 30.6 and 25.7, and the mean visual analog scale (VAS) scores for back/leg pain improved by 2.4/2.5 and 3.8/4.2 for the HYB and cMIS groups, respectively. There was no significant difference between groups with regard to ODI or VAS scores. For the HYB group, the lumbar coronal Cobb angle decreased by 13.5°, lumbar lordosis (LL) increased by 8.2°, sagittal vertical axis (SVA) decreased by 2.2 mm, and LL-pelvic incidence (LL-PI) mismatch decreased by 8.6°. For the cMIS group, the lumbar coronal Cobb angle decreased by 10.3°, LL improved by 3.0°, SVA increased by 2.1 mm, and LL-PI decreased by 2.2°. There were no significant differences in these radiographic parameters between groups. The complication rate, however, was higher in the HYB group (55%) than in the cMIS group (33%) (p = 0.024). CONCLUSIONS: Both HYB and cMIS approaches resulted in clinical improvement, as evidenced by decreased ODI and VAS pain scores. While there was no significant difference in degree of radiographic correction between groups, the HYB group had greater absolute improvement in degree of lumbar coronal Cobb angle correction, increased LL, decreased SVA, and decreased LL-PI. The complication rate, however, was higher with the HYB approach than with the cMIS approach.

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Published In

J Neurosurg Spine

DOI

EISSN

1547-5646

Publication Date

April 2015

Volume

22

Issue

4

Start / End Page

374 / 380

Location

United States

Related Subject Headings

  • Visual Analog Scale
  • Spinal Fusion
  • Scoliosis
  • Retrospective Studies
  • Radiography
  • Postoperative Complications
  • Orthopedics
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Park, P., Wang, M. Y., Lafage, V., Nguyen, S., Ziewacz, J., Okonkwo, D. O., … International Spine Study Group, . (2015). Comparison of two minimally invasive surgery strategies to treat adult spinal deformity. J Neurosurg Spine, 22(4), 374–380. https://doi.org/10.3171/2014.9.SPINE131004
Park, Paul, Michael Y. Wang, Virginie Lafage, Stacie Nguyen, John Ziewacz, David O. Okonkwo, Juan S. Uribe, et al. “Comparison of two minimally invasive surgery strategies to treat adult spinal deformity.J Neurosurg Spine 22, no. 4 (April 2015): 374–80. https://doi.org/10.3171/2014.9.SPINE131004.
Park P, Wang MY, Lafage V, Nguyen S, Ziewacz J, Okonkwo DO, et al. Comparison of two minimally invasive surgery strategies to treat adult spinal deformity. J Neurosurg Spine. 2015 Apr;22(4):374–80.
Park, Paul, et al. “Comparison of two minimally invasive surgery strategies to treat adult spinal deformity.J Neurosurg Spine, vol. 22, no. 4, Apr. 2015, pp. 374–80. Pubmed, doi:10.3171/2014.9.SPINE131004.
Park P, Wang MY, Lafage V, Nguyen S, Ziewacz J, Okonkwo DO, Uribe JS, Eastlack RK, Anand N, Haque R, Fessler RG, Kanter AS, Deviren V, La Marca F, Smith JS, Shaffrey CI, Mundis GM, Mummaneni PV, International Spine Study Group. Comparison of two minimally invasive surgery strategies to treat adult spinal deformity. J Neurosurg Spine. 2015 Apr;22(4):374–380.

Published In

J Neurosurg Spine

DOI

EISSN

1547-5646

Publication Date

April 2015

Volume

22

Issue

4

Start / End Page

374 / 380

Location

United States

Related Subject Headings

  • Visual Analog Scale
  • Spinal Fusion
  • Scoliosis
  • Retrospective Studies
  • Radiography
  • Postoperative Complications
  • Orthopedics
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male